On June 6, the Supreme Court of Canada’s decision making physician-hastened death legal will come into effect. A parliamentary committee asked to help the government plot how that would roll out in Canada has made some far-reaching recommendations, well beyond what was contemplated by the court in Carter v. Canada.
The moment we are born, our lives take flight; and the longer we are airborne, the greater the chance of encountering turbulence along the way. While every flight is destined to land, some landings are harder to contemplate than others.
Who but those who have experienced it can appreciate the soul crushing anguish of mental illness? Afflictions of the mind can be paralyzing and fundamentally change the way we perceive ourselves (I am worthless), anticipate the future (my prospects are hopeless), and experience the world (life is unfair and unforgiving). The combination of self-loathing, hopelessness and despair can tragically lead to suicide.
A few days after the Supreme Court of Canada overturned the prohibition against medical aid in dying, I received a note from a wonderful colleague of mine saying that her closest friend’s 53 year old son had just died of spinal cancer.
The last time I was in Israel, I went on some home visits with a palliative care physician in the town of Sfat near the Sea of Galilee. My colleague, a devout Jewish doctor, took me to several homes to offer advice on managing his most serious, terminally ill patients. One older Chassidic Rabbi was dealing with an advanced lung cancer, and having a difficult time accepting any kind of help from his young adult children.
Advance care planning is a process of reflection and communication about personal care preferences in the event that an individual becomes incapable of consenting to or refusing treatment or other care. The most important aspects of advance care planning are choosing one or more Substitute Decision Makers — someone who will speak on the individuals’ behalf and make decisions for them if they are not able to do so themselves.